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Lobbyist Money Help  

Bill to Drop One Rural Ambulance Technician

February 16, 1998
By: Bradley Brown
MDN Columbia Bureau

The Director of Ambulance Services in rural Drexel, Missouri received an emergency call -- a woman was having trouble breathing. There were no ambulances available so Gale Allman drove his own car to the scene.

There, he met the fire chief and began to treat the woman. Allman had to wait for almost an hour until an ambulance arrived. The victim might have died. But what Allman did was illegal.

Missouri regulations require two emergency medical technicians, or EMTs, on an ambulance. Allman believes one is enough.

State Senator Harold Caskey from neighboring Butler, has introduced legislation to change state regulations. Under Senate Bill 625, only one EMT would need to be available.

Allman says he would replace the other with a police or fire person, "We can actually increase the quality of care with one EMT. I can remember when a guy crashed his motorcycle. We were on the scene immediately. Luckily he was in town. Had he been out a few miles I don't think he would have survived."

Allman supervises a group of six volunteers trained in emergency medicine. He is trying to improve rural ambulance service to his area, located 45 miles south of Kansas City.

Caskey says, "It's the difference between no service and some service. As far as emergency medical treatment is concerned, these folks are the first responders to many situations where a life may be saved or lost depending on how quickly an ambulance can get there."

Because Drexel's ambulance service is volunteer, there are times when two people aren't available to respond to calls. Allman must then wait for an EMT or Harrisonville 17 miles away--the nearest city with ambulance service.

Allman says the replacement person would be trained in basic life support and assist the EMT.

Allman says, "They would just drive the vehicle,"

The US Census Bureau reports over one-point-six million Missourians live in rural areas. Allman says the four million urban residents would not be affected in any way.

Caskey says, "We'll be able to save our ambulance service. Because of the requirements right now placed on the delivery of ambulance service, rural areas are not able to qualify."

Opposition to Caskey's bill has surfaced because of changes in the areas an ambulance provider can serve. For instance, the St. Louis metropolitan area would be split into nearly 100 subdivisions. Abbott Ambulance Service is based in St. Louis.

Matthew McCormick is a lobbyist for Abbot. He says, "There's been a lot of disagreement over a small portion of the bill. 90 percent of E-M-S legislation that's been introduced has been supported by 99-point-nine percent of all ambulance service providers to date."

Each subdivision would be able to create it's own regulations for ambulance service. McCormick says the bill would maintain current ambulance service areas, but transferring patients across service lines would be a complex procedure.

McCormick says, "[Abbott] really believes Senator Caskey has the best interest of E-M-S at heart. I think that before all is said and done, there will be a piece of legislation that [Abbott] will be able to support."

MAST provides ambulance service for Kansas City and the surrounding area. MAST stands for Metropolitan Ambulance Services Trust. Administrative Assistant Jason White ways M-A-S-T does not support the bill.

White says, "[Senator Caskey] ended up with what an official at the [Missouri] Department of Health wrote. The officials in the Department of Health don't run ambulances."

32 states including Kansas and Oklahoma have similar legislation.

The Journal of Emergency Medical Services researches issues associated with the ambulance industry. The Director of Research for J-E-M-S says, "There is a slight trend downward from two paramedics, to one paramedic and another individual."

Ty Mayfield also says, "There are some states that allow uncertified people on ambulances."

Changing the legislation was Allman's only option. Drexel would not be able to support a paid ambulance staff, says Allman. He estimates the costs of running an ambulance service to be 150 thousand dollars a year.

Allman says, "And that's paying people seven dollars an hour. We can't hope to keep people at that rate. The turnover would be tremendous."

Because of Drexel's tax structure, not even half of the anticipated costs would be able to be met.

Allman says, "Basically, this is something positive that's going to help rural Missouri."

The bill is now on the senate floor, having passed through committee last week.